title: Quality of life: a potentially useful measure to indicate subclinical flares in Crohn disease.
abstract: BACKGROUND
  While quality of life (QoL) is a well-recognised outcome measure of Crohn disease (CD) activity, its influence on other outcome measures, including exacerbation of CD is poorly understood. If QoL measures were to be associated with intestinal inflammatory activity, they might be useful for early detection of subclinical flares.
  
  
  OBJECTIVE
  We hypothesised that low QoL might be associated with subsequent CD flares.
  
  
  METHODS
  A cohort of 318 adult CD patients was observed for 1 year after assessment of baseline characteristics. Data were collected in Swiss university hospitals, regional hospitals and private practices. At inclusion, patients completed the Inflammatory Bowel Disease QoL Questionnaire (gastrointestinal QoL; range: 32 to 224 points) and the Short Form-36 Health Survey (general QoL; range: 35 to 145 points). During follow up, flares were recorded. Binary logistic regression was performed to estimate the relation between QoL and the odds of subsequent flares.
  
  
  RESULTS
  A twofold decrease in the odds of flares (99% CI: 1.1; 4.0) per standard deviation of gastrointestinal QoL and a threefold decrease (99% CI: 1.5; 6.2) per standard deviation of general QoL were observed.
  
  
  CONCLUSIONS
  The close association between QoL and subsequent flares suggests that QoL measures might be useful in detecting upcoming flares before they become clinically apparent.
authors.affiliation: Department of General Internal Medicine, Division of Psychosomatic Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
authors.forename: R J A
authors.initials: RJ
authors.lastname: Cámara
authors.forename: P
authors.initials: P
authors.lastname: Juillerat
authors.forename: V
authors.initials: V
authors.lastname: Pittet
authors.forename: A M
authors.initials: AM
authors.lastname: Schoepfer
authors.forename: S
authors.initials: S
authors.lastname: Begré
authors.forename: R
authors.initials: R
authors.lastname: von Känel
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003424:Crohn Disease / Q000175:diagnosis* / Q000401:mortality / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys / Q000379:methods / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards; D015996:Survival Rate / Q000639:trends